**4.6 Specific phobia**

*Anxiety Disorders - The New Achievements*

• Alcohol Withdrawal Syndrome

• Cardiac arrhythmias

• Hyperthyroidism

• Cushing's Disease

stress disorder and alcoholism.

• Hypoglycemia

• Asthma

the patient [15].

**4.4 Agoraphobia**

• Substance Withdrawal Syndrome

diagnoses cause a negative course in panic disorder.

**4.5 Social phobia (social anxiety disorder)**

as palpitations, accelerated heart rate, sweating, trembling/shaking, shortness of breath, feeling of choking, breathlessness, chest pain, fainting, fear of losing control or going crazy, numbness, tingling, chills or hot flushes can be seen.

are some medical conditions that cause symptoms similar to panic attacks.

The presence of a medical drum that may cause anxiety should first be investigated in a patient presenting with panic attack. All the drugs used by the individual should be questioned, and the side effects of the drugs should be considered. Below

**Certain medical conditions that produce symptoms similar to panic attacks**

The majority of patients have challenging life events before the first panic attack occurs. Low socio-economic level, delay in treatment, presence of additional

Comorbidity: Depression is seen with social phobia, specific phobia, traumatic

Treatment: Specific serotonin reuptake inhibitors should be the first choice in the treatment of panic disorder. If the patient does not respond to treatment, switching to other specific serotonin reuptake inhibitors is recommended. If there is no response to two specific serotonin reuptake inhibitors and there is severe tolerance, it is recommended to switch to SNRI. Alprazolan is also highly effective. Drug treatment should last at least a year. Behavioral-cognitive psychotherapy is an effective method in panic disorder. This method attempts to change the patient's perception of physical symptoms. It will be useful to teach breathing exercises to

Agoraphobia, which is shortly defined as the fear of open space, is the fear of

*Treatment:* Combination of pharmacotherapy and psychotherapy (behavioral, cognitive, virtual therapies) is recommended in its treatment. Benzodiazepines, SSRIs, tricyclic and tetracyclicantidepressants are recommended as diocological [15].

It is a disorder characterized by blushing, sweating, and trembling of the hands when one believes that s/he is perceived negatively by others while sitting or talking in public. The individual is afraid of social or performance situations where embarrassment can occur and firmly believes that s/he will be subject to possible reproach by others [12]. The onset of the symptoms of this disorder often occurs in

being deprived of help or being in places where it is difficult to escape.

**86**

It is an excessive, illogical and meaningless fear of a specific object (snake, dog, etc.) or a situation (injection, darkness, etc.). Exposure to phobic stimulus produces compelling panic symptoms, including palpitations, sweating, dizziness and difficulty in breathing. Phobias can begin at any age. People can be phobic towards almost any object or situation. Those that start in childhood often disappear without treatment. But those that start in adulthood or are persistent often require therapeutic support. The disorder is diagnosed more often in females than in males [16]. The specific classification of simple phobias is given in **Table 1**.

*Treatment:* It is not enough to use drugs alone in the treatment of specific phobias. Behavioral therapy, insight-oriented therapy, virtual therapy and pharmacotherapy are at the forefront in its treatment [17]. The main principle of treatment should be exposure to the feared situation. When the phobia is accompanied by panic attacks, beta-adrenergic receptor antagonists or benzodiazepines can be used. The combined use of pharmacotherapy and psychotherapy may also be effective.
